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Published on: September 24, 2020
COVID-19 Transmission and Clinical Features in Pediatric Intensive Care Health Care Workers
Edin Botan1, Emel Uyar2, Zeynelabidin Öztürk3
1Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara, Turkey.
Insights
Coronavirus disease 2019 (COVID-19) poses a significant risk to healthcare workers in pediatric intensive care units. Patient care procedures like intubation and ventilation are key transmission points, emphasizing the need for full personal protective equipment.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Occupational Health
Background:
- Coronavirus disease 2019 (COVID-19) presents unique challenges in pediatric intensive care units (PICUs).
- Understanding transmission routes and clinical impact on healthcare workers (HCWs) in PICUs is crucial for patient and staff safety.
Purpose of the Study:
- To investigate the modes of transmission of COVID-19 among HCWs in PICUs.
- To describe the clinical features and outcomes of COVID-19 in this specific high-risk population.
Main Methods:
- A multicenter descriptive study was conducted from March to November 2020.
- Data collected included patient demographics, COVID-19 origin, clinical characteristics, treatment, and work absences for 768 HCWs across 16 PICUs.
Main Results:
- 114 (14.8%) HCWs contracted COVID-19, with a mean age of 29.7 years; 66.7% were female.
- Physicians (54.3%) and nurses (34.2%) were most affected. Patient contact was the primary transmission source (54.3%).
- Key transmission events included endotracheal intubation (21%), cardiopulmonary resuscitation (9.6%), and non-invasive ventilation (12.2%). 13.1% required intensive care, but no fatalities occurred.
Conclusions:
- COVID-19 is a significant occupational hazard for PICU HCWs.
- Transmission frequently occurs during aerosol-generating procedures, underscoring the critical importance of stringent personal protective equipment (PPE) use during all patient care activities.
Objective:
This study aims to investigate modes of transmission and clinical features of coronavirus disease 2019 in healthcare workers in pediatric intensive care units.
Materials And Methods:
This multicenter descriptive study was conducted between March and November 2020. Patient demographics, clinical characteristics, origin of coronavirus disease 2019, treatment modalities, and loss of workdays were recorded.
Results:
Seven hundred and sixty-eight healthcare workers from 16 pediatric intensive care units were enrolled and 114 (14.8%) healthcare workers with a mean age of 29.7 ± 6.7 years became coronavirus disease 2019 patients. Seventy-six (66.7%) patients were female. Approximately half (54.3%) of the patients were physicians, 34.2% were nurses, and 11.4% were ancillary staff. Transmission was deemed to occur through patient contact in 54.3% of the patients. Comorbid illness was present 10.5% of the patients. Transmission occurred during endotracheal intubation in 21%, cardiopulmonary resuscitation in 9.6%, and non-invasive ventilation in 12.2% of patients, while transmission was a result of multiple possible procedures in 43.8%. Intensive care admission was needed for 13.1% of the patients. Five patients needed oxygen by cannula, 7 needed oxygen with a non-rebreathing mask, 5 needed high-flow nasal cannula support, 5 needed non-invasive ventilation, and 3 needed invasive mechanical ventilation. Fortunately, no infected healthcare workers died.
Conclusion:
Coronavirus disease 2019 in healthcare workers is a significant problem in pediatric intensive care units. Transmission seems to occur particularly frequently during patient care procedures such as intubation, ventilation and aerosol therapy, which highlights the importance of proper use of full sets of personal protective equipment during all procedures during care of coronavirus disease 2019 patients.
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